A Mobile, Electronic Health Record-Connected Application for Managing Team Workflows in Inpatient Care

With improving clinician workflows as our priority, we initially planned to create a digital handoff tool to replace printed documents. However, user inquiries revealed that shift-to-shift handoff was only one of many workflows needing better support. Other identified vulnerabilities included: effective visualizations of laboratory and other structured data, collaborative task management, and transitions of care both within a team (e.g., night coverage) and across teams (e.g., intensive care unit to ward).

Learning from prior examples of institutional systems designed to improve clinicians’ interactions with EHR functionalities, we recognized opportunities to leverage recent advances—mobile technology, facile web application interfaces, and data interoperability — in the creation of a homegrown EHR-adjunct that provides a modern digital experience. We therefore broadened our scope, aiming to develop a comprehensive digital workflow application that would provide quick access to real-time clinical data and a team-based care planning workspace that would support handoff, task-management, and other processes. Key requirements included full mobile functionality, collaborative access within and between interdisciplinary teams, and the ability to customize views of data for different user workflows. Rather than the static snapshot captured on list printouts, which become outdated within hours of printing, we wanted our tool to be a dynamic, live view of the patient’s state. By designing an application to support evolving team workflows, we hoped to increase transparency between clinicians, improve communication, and reduce errors. This article describes our process, from ideation and development through implementation, and the research findings of objective use, efficacy, and efficiency, along with qualitative assessments of user experiences.